Student Information Form Please complete the form below so that we may better serve you. First name* Last name* Email* What group have you been assigned to?* —Please choose an option—JUMP Jamaica C01-G01JUMP Jamaica C01-G02JUMP Jamaica C01-G03JUMP Jamaica C01-G04JUMP Jamaica C01-G05JUMP Jamaica C01-G06JUMP Jamaica C01-G07JUMP Jamaica C01-G08JUMP Jamaica C01-G09 When is your birthday? How old are you?* What is your sex? MaleFemalePrefer not to say Contact number* What country are you applying from?* —Please choose an option—BahamasBarbadosDominican RepublicGrenadaGuyanaHaitiJamaicaSt. LuciaTrinidad and TobagoBelizeOther Mailing address What is your nationality?* Select the item below that best describes your level of education PrimarySecondaryTertiary/VocationalUndergraduateGraduatePost-Graduate Select the item below that best describes your marital status SingleMarriedCommon-LawDivorcedWidowed Are you the head of your household? NoYes Do you have any children? NoYes How many children do you have?* How would you describe the financial status of your family? Below the poverty lineOn the poverty lineJust above the poverty lineComfortably above the poverty lineWell above the poverty line What is your current primary source of income?* How long has this been your primary source of income?* How long do you expect this will continue to be your primary source of income?* Do you depend on someone for financial support? NoYes Does anyone depend on you for financial support? NoYes Do you have any kind of disability? NoYes What disability do you have?* Please explain your interest in ICT and Digital Skills* Do you have any special skills you would like to tell us about? NoYesPrefer not to say Tell us about your special skills* How did you hear about the Caribbean School of Data? In the mediaFrom a friendFrom someone who knew about the program Please indicate all of the following devices that you OWN:* Mobile phone ('banger')SmartphoneTabletLaptopDesktop Do you have access to the Internet from your home? NoYesPrefer not to say Do you have mobile access to the Internet? NoYesPrefer not to say Do you have access to the Internet from your workplace? NoYesPrefer not to say
